New classification of maxillary ameloblastic carcinoma based on an evidence-based literature review over the last 60 years

Abstract

Background: The ameloblastic carcinoma is a rare malignant odontogenic tumor which rather occurs in the mandible than in the maxilla. Its rarity and in this context somewhat speculative histopathogenesis may account for diagnostic difficulties. Current classifications do not consider benign histopathological features at the primary and malignant features at the metastatic tumour site. Based on an evidence-based literature review, a recommendation for a novel classification is presented.

Ameloblastic carcinoma of the maxilla: A rare case presentation and a review of new cases

“…[2,6,[8][9][10][11][12][13] The age ranges from 21 to 77 years (mean age: 57.1 years) and the male to female ratio was 7.5:1, which was consistent with the Kruse et al report. [3] Most of the lesions (88.2%) similar to the present case and to previously reported cases occurred in the posterior portion of the maxilla. [7,8,11] Clinically, swelling was the first clinical symptom in 94.1% of cases.…”

“…Importantly, adjuvant radiotherapy in patients with positive lymph nodes, positive resection margins and perineural invasion is suggested. [3,7] Radiotherapy alone for patients with advanced local or metastatic AC or who are not surgical candidate seems appropriate. [7,10] Owing to the small number of cases, elective radical neck dissection is still under review but radical neck dissection for tumors with evidence of positive cervical lymph nodes is recommended.…”

“…They reported 26 cases of maxillary AC from 1948 to 2008. [3] Reporting new cases can provide a better understanding of clinical characteristics, biologic behavior and treatment modality of AC.…”

Low-Grade Spindle-Cell Ameloblastic Carcinoma: Report of an Unusual Case with Immunohistochemical Findings and Review of the Literature

“…In 1974, Shafer introduced the term "ameloblastic carcinoma" to describe ameloblastomas in which histologic malignant formation occurs 7 . The term "metastasizing ('malignant') ameloblastoma" was applied to an ameloblastoma that metastasizes and yet reveals a benign or typical appearance in both the primary and the metastatic lesions 8 5 recommended a modified classification in which a primary ameloblastoma is followed by secondary metastasis with histopathologic features of malignancy and without evidence of malignancy in the primary location.…”

“…Although ameloblastic carcinoma was recognized very early by others [3][4][5] , the World Health Organization (who) classifications of 1971 6 and 1992 7 did not include the term in the section on odontogenic Current OnCOlOgy-VOlume 17, number 5 seen in the submandibular region 4-5 cm from the midline on the left side of the chin. The swelling was non-tender, variable in consistency, nonfluctuant, non-compressible, and fixed to underlying structures.…”